Overview of recent advances in molecular cardiology

Abstract

R apid advances in molecular biology in the past decade have changed the practice of clinical cardiology by increasing understanding of molecular mechanisms of cardiovascular disease, and providing new diagnostic and therapeutic tools. It is expected that knowledge in molecular cardiology will grow exponentially in the next few years. Already, molecular and genetic cardiology has increased awareness of the inheritance of defective genes and their impact on cardiovascular disease. Subsequently, there have been numerous attempts to apply this new knowledge at the bedside. However, routine molecular genetic testing or DNA analysis is not available in most hospitals or clinical chemistry laboratories. In addition, there are few powerful molecular biology tests and gene therapy protocols established for treating cardiovascular diseases, mainly due to a lack of dependable techniques. Thus, there is an urgent demand for the advancement of efficient and dependable molecular cardiology techniques.The development of molecular cardiology depends on the availability of established molecular biology techniques. There have been several major advances in the area of molecular biology that have contributed significantly to the field of molecular cardiology: the discovery and application of specific restriction endonucleases and reverse transcriptase; the development of cloning techniques; the availability of rapid DNA sequencing; the improvement in vector technology; and the completion or near completion of human and animal genomes. These advances will allow us to understand the gene regulation of cardiac and vascular growth, identify genes responsible for cardiovascular diseases, perform diagnostic in situ hybridization and develop gene therapy approaches to cardiovascular diseases.The present review covers the following four areas: gene analysis in the injured and hypertrophied heart; transgenic techniques in cardiac research; gene transfer and gene therapy for cardiovascular disease; and stem cell therapy for cardiovascular disease. GENE ANALYSIS IN THE DISEASED HEARTThere is increasing evidence indicating that cardiovascular diseases are associated with changes in gene expression. Identification of new candidate genes involved in heart diseases will provide the molecular basis for diagnosis, prevention and intervention. It is important to determine if the changes in gene expression cause heart diseases or are secondary to heart disease.Cardiac hypertrophy is the most common risk factor contributing to cardiovascular mortality and morbidity. The pathogenesis of cardiac hypertrophy is multifactorial, with Molecular cardiology is a new and fast-growing area of cardiovascular medicine that aims to apply molecular biology techniques for the mechanistic investigation, diagnosis, prevention and treatment of cardiovascular disease. As an emerging discipline, it has changed conceptual thinking of cardiovascular development, disease etiology and pathophysiology. Although molecular cardiology is still at a very early stage, it has ope...

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